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_______________________________________________________________________
MedPulse is a weekly index of key news and features on Medscape's
specialty sites compiled by Medscape's Editors.
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___________________ NEW FEATURE ARTICLES THIS WEEK ____________________
-- MEDSCAPE ORIGINAL ARTICLES --
ANEMIA, NEUTROPENIA, AND THROMBOCYTOPENIA: PATHOGENESIS AND EVOLVING TREATMENT
OPTIONS IN HIV-INFECTED PATIENTS
Fully updated: Alexandra Levine, MD, presents a comprehensive review of the
management of anemia, neutropenia, and thrombocytopenia in HIV-infected
patients.
Medscape Clinical Update
medscape.com/viewprogram/669?srcmp=id-060702
MASTERS OF PEDIATRICS: INFECTIOUS DISEASE UPDATE 1
This program discusses the clinical bacterial conditions that can occur in the
child and the antibiotic classes used to treat them, followed by a review of
vaccine-preventable diseases and immunization strategies.
Medscape CME Circle
medscape.com/viewprogram/1823?srcmp=id-060702
MASTERS OF PEDIATRICS: INFECTIOUS DISEASE UPDATE 2
The urinary tract is the most common site for serious bacterial infection in
children. Diagnostic and treatment issues for this condition are reviewed.
Medscape CME Circle
medscape.com/viewprogram/1824?srcmp=id-060702
PREVENTING INFLUENZA: NEW OPPORTUNITIES FOR AN OLD DISEASE
Prevention is key with influenza, but vaccination is underutilized. This program
addresses the impact of influenza, the immune response mechanism and protection
with vaccines, and strategies to reduce the spread of influenza in the
community.
Medscape CME Circle
medscape.com/viewprogram/1840?srcmp=id-060702
KIDNEY TRANSPLANT CANDIDATE WITH HCV INFECTION?
What is the indication for a liver biopsy in the HCV-positive patient waiting
for renal transplant?
Medscape Transplantation 3(1) 2002
medscape.com/viewarticle/434067?srcmp=id-060702
-- EMERGING INFECTIOUS DISEASES --
HOSPITAL-BASED DIAGNOSIS OF HEMORRHAGIC FEVER, ENCEPHALITIS, AND HEPATITIS IN
CAMBODIAN CHILDREN
Dengue rates were as high as 10.6/100 hospital admissions in September 1998.
Emerg Infect Dis 8(5) 2002
medscape.com/viewarticle/432529?srcmp=id-060702
SENTINEL SURVEILLANCE: A RELIABLE WAY TO TRACK ANTIBIOTIC RESISTANCE IN
COMMUNITIES?
Sentinel surveillance for resistant pneumococci rarely detects newly emerging
resistance profiles.
Emerg Infect Dis 8(5) 2002
medscape.com/viewarticle/432533?srcmp=id-060702
INCREASING QUINOLONE RESISTANCE IN SALMONELLA ENTERICA SEROTYPE ENTERITIDIS
Data from Denmark show that quinolone resistance in S. Enteritidis has increased
from 0.8% in 1995 to 8.5% in 2000.
Emerg Infect Dis 8(5) 2002
medscape.com/viewarticle/432535?srcmp=id-060702
CD REVIEW: ACUTE RESPIRATORY INFECTION CD MODULE
Given the required sophisticated software and cost, its usefulness in the
developing world is questionable.
Emerg Infect Dis 8(5) 2002
medscape.com/viewarticle/432553?srcmp=id-060702
LETTER: FIRST SHIGA TOXIN-PRODUCING ESCHERICHIA COLI ISOLATE FROM A PATIENT WITH
HEMOLYTIC UREMIC SYNDROME, BRAZIL
We describe the case of an 8-month-old boy with anemia, oliguria, and edema of
the lower extremities.
Emerg Infect Dis 8(5) 2002
medscape.com/viewarticle/432551?srcmp=id-060702
-- INFECTIONS in MEDICINE --
IMAGES IN INFECTIOUS DISEASE - DISSEMINATED CRYPTOCOCCOSIS
A 30-year-old woman presented to the ED with a disfiguring nodular rash on her
face and right-eye blindness.
Infect Med 19(4) 2002
medscape.com/viewarticle/433138?srcmp=id-060702
ABSTRACTS IN HEPATITIS - RECENT FINDINGS IN THE JOURNALS
Experts comment on findings in hepatitis B vaccination compliance and
post-transplantation hepatitis C.
Infect Med 19(4) 2002
medscape.com/viewarticle/433136?srcmp=id-060702
-- THE AIDS READER --
"SCIENTIFIC GAMBLES": AIDS MICROBICIDES AND VACCINES
The 2 most promising biologic means of AIDS prevention may prove to be the most
difficult challenges in AIDS research.
AIDS Read 12(3) 2002
medscape.com/viewarticle/433557?srcmp=id-060702
CONDYLOMA ACUMINATUM PRESENTING AS A DORSAL TONGUE LESION IN A PATIENT WITH AIDS
A man with advanced AIDS presented with nonpainful but enlarging dorsal tongue
soft tissue growth of 6 months' duration.
AIDS Read 12(4) 2002
medscape.com/viewarticle/434012?srcmp=id-060702
ACHIEVING ADHERENCE WITH ANTIRETROVIRAL MEDICATIONS FOR PEDIATRIC HIV DISEASE
Adherence strategies depend heavily on family support and resolution of
disclosure issues in the household.
AIDS Read 12(4) 2002
medscape.com/viewarticle/434009?srcmp=id-060702
IDENTIFYING AND MANAGING MORPHOLOGIC COMPLICATIONS OF HIV AND HAART
Ultimately, patient self-reporting and anthropometric measurement may be the
best tools to assess morphologic changes.
AIDS Read 12(3) 2002
medscape.com/viewarticle/433556?srcmp=id-060702
-- OTHER JOURNALS --
THE MOLECULAR CHARACTERIZATION OF FATAL INFECTIOUS MONONUCLEOSIS
FIM is associated most frequently with Epstein-Barr virus infection of an
immunocompromised host.
Am J Clin Pathol 117(4) 2002
medscape.com/viewarticle/433609?srcmp=id-060702
HOW TO ADVERTISE IN MEDPULSE
For information on advertising in our e-mail newsletters -- like this MedPulse
you are reading -- or other creative advertising opportunities with WebMD
Medscape Health Networks, please send an email to:
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INFECTION RISK FROM NONSTERILE ENTERAL FORMULA
Heighten your awareness of infection risk from use of
nonsterile enteral formula in the NICU. Review "Enterobacter
sakazakii Infections Associated With the Use of Powdered Infant
Formula - Tennessee, 2001,Ó accessible via the Articles link
in the Sepsis Resource Center:
medscape.com/mp/rc/usmd/sepsis
RECOMBINANT ANTIBODY FRAGMENTS MAY PROVIDE ANTHRAX PROTECTION
Researchers have developed recombinant fragments of naturally occurring, anthrax
toxin-neutralizing monoclonal antibodies that possess higher affinity for the
toxin than the native proteins, according to a report in Nature Biotechnology
for June.
Reuters Health Information 2002
medscape.com/viewarticle/434503?srcmp=id-060702
SHIFT IN SMALLPOX VACCINATION POLICY RECOMMENDED
Several experts urged federal officials on Tuesday to implement a broad shift in
government policy that would include voluntary, preemptive smallpox vaccination
for most US citizens.
Reuters Health Information 2002
medscape.com/viewarticle/435969?srcmp=id-060702
BILL TO OFFER INDUSTRY INCENTIVES FOR ANTI-BIOTERROR PRODUCTS
The US Senate will soon see a bill designed to offer broad incentives to
pharmaceutical and biotechnology companies who agree to supply the government
with bioterrorism countermeasures, a Senate aide said Tuesday.
Reuters Health Information 2002
medscape.com/viewarticle/435979?srcmp=id-060702
HOMELAND SECURITY PLAN'S EFFECT ON HEALTH ISSUES IS HARD TO PREDICT, LAWMAKERS
SAY
President Bush's plan to form a new cabinet-level Department of Homeland
Security gained favorable reviews on Capitol Hill Thursday, though some
lawmakers said they were reserving judgment about how the plan would work to
protect Americans against biological attacks.
Reuters Health Information 2002
medscape.com/viewarticle/436181?srcmp=id-060702
-- STDs --
SEXUALLY TRANSMITTED INFECTIONS INCREASING IN WESTERN EUROPE
From the late 1980s through the early 1990s, sexually transmitted infection (STI)
rates fell in many western European countries.
Reuters Health Information 2002
medscape.com/viewarticle/434518?srcmp=id-060702
CIDOFOVIR EFFECTIVE AGAINST HPV-INDUCED SKIN LESIONS
Cidofovir, an acyclic nucleoside phosphonate analogue with broad-spectrum
activity against DNA viruses, can result in a complete response in patients with
human papilloma virus (HPV)-induced lesions, according to a report in the June
issue of the Journal of Medical Virology.
Reuters Health Information 2002
medscape.com/viewarticle/436195?srcmp=id-060702
CYTYC'S THINPREP WINS EXPANDED FDA CLEARANCE
Boxborough, Massachusetts-based Cytyc Corp. said on Thursday that the US Food
and Drug Administration has cleared testing for chlamydia and gonorrhea directly
from the company's ThinPrep Pap Test collection vial using Roche Diagnostics
Corp.'s COBAS Amplicor automated system.
Reuters Health Information 2002
medscape.com/viewarticle/436178?srcmp=id-060702
-- GI TRACT --
G2 STRAIN OF ROTAVIRUS ASSOCIATED WITH DIARRHEA OUTBREAKS IN ADULTS
The US Centers for Disease Control and Prevention identified three outbreaks of
gastroenteritis among adults that were all associated with the same uncommon G2
strain of rotavirus.
Reuters Health Information 2002
medscape.com/viewarticle/435973?srcmp=id-060702
CHANGES IN GENE EXPRESSION DURING INFECTION INCREASE INFECTIVITY OF V. CHOLERAE
After passing through the human intestine, the gene expression profile of Vibrio
cholerae alters to a hyperinfectious state, investigators report in the June 6th
issue of Nature, which probably explains the rapid spread of cholera during
epidemics.
Reuters Health Information 2002
medscape.com/viewarticle/436093?srcmp=id-060702
PROBIOTICS CAN PREVENT ANTIBIOTIC-ASSOCIATED DIARRHEA
The results of a meta-analysis by UK researchers indicate that probiotics are
useful in preventing diarrhea associated with antibiotic use, and that yeast and
lactobacilli are particularly useful in this situation.
Reuters Health Information 2002
medscape.com/viewarticle/436202?srcmp=id-060702
-- SEPSIS --
PIRFENIDONE MAY THWART ENDOTOXIN-INDUCED SHOCK
Pirfenidone, an antifibrotic agent, is a potentially 'excellent' therapeutic
agent for septic and staphylococcal endotoxin (SE)-induced shock, investigators
report in the June issue of the journal Infection and Immunity.
Reuters Health Information 2002
medscape.com/viewarticle/435925?srcmp=id-060702
HEMOPERFUSION IMPROVES BLOOD PRESSURE IN SEPTIC SHOCK PATIENTS
Direct hemoperfusion with an adsorbent column using polymyxin B-immobilized
fiber improves mean arterial pressure in patients with septic shock, Japanese
investigators report, regardless of whether the causative organism is
gram-negative or gram-positive.
Reuters Health Information 2002
medscape.com/viewarticle/436184?srcmp=id-060702
-- HEPATITIS --
CHINA LAUNCHES HEPATITIS B VACCINE PROJECT
China and international health groups launched on Saturday a $75 million project
to vaccinate newborns against the hepatitis B virus, which kills an estimated
250,000 annually in the world's most populous country.
Reuters Health Information 2002
medscape.com/viewarticle/435921?srcmp=id-060702
IRON REMOVAL MAY IMPROVE EFFECTIVENESS OF INTERFERON FOR CHRONIC HEPATITIS C
In patients with chronic hepatitis C, iron removal by phlebotomy appears to
improve the sustained response rate to interferon, according to a recent report
by Italian researchers.
Reuters Health Information 2002
medscape.com/viewarticle/435996?srcmp=id-060702
US INSTITUTE OF MEDICINE FINDS HEPATITIS B VACCINE SAFE
There is no hard link between hepatitis B vaccination and later development of
multiple sclerosis (MS) and other neurological diseases in adults, a federally
funded scientific panel concluded in a report released Thursday.
Reuters Health Information 2002
medscape.com/viewarticle/434489?srcmp=id-060702
-- CJD/BSE --
ISRAEL REPORTS FIRST CASE OF MAD COW DISEASE
Israel confirmed on Wednesday its first case of mad cow disease, found in a
10-year-old cow in the Golan Heights.
Reuters Health Information 2002
medscape.com/viewarticle/435968?srcmp=id-060702
NEW BLOOD DONOR LIMITS TAKE EFFECT IN US
New limits on blood donations from certain individuals who have spent time in
Europe take effect in the US on Friday protect the blood supply against bovine
spongiform encephalopathy (mad cow disease)-and blood banks say they could face
shortages.
Reuters Health Information 2002
medscape.com/viewarticle/434490?srcmp=id-060702
-- INFLUENZA --
SWISS BIOTECH DROPS FLU SPRAY; SHARES FALL
Berna Biotech said on Thursday it has dropped its key Nasalflu influenza spray
after studies could not rule out a possible link to temporary facial paralysis,
sending its stock skidding lower.
Reuters Health Information 2002
medscape.com/viewarticle/436208?srcmp=id-060702
-- ANTIBIOTIC RESISTANCE --
SUBSTANTIAL PREVALENCE OF MRSA FOUND IN UK SURGICAL PATIENTS ON ADMISSION
One in 20 patients admitted to hospital for surgery are already colonised with
methicillin-resistant Staphylococcus aureus (MRSA), suggesting that presurgical
screening and prophylaxis could help avoid infectious complications, according
to new research findings.
Reuters Health Information 2002
medscape.com/viewarticle/434486?srcmp=id-060702
-- MALARIA --
MALARIA OUTCOMES NO WORSE AMONG INJECTION DRUG USERS
Though it has been assumed that injection drug users who contract malaria from
contaminated needles face a poorer prognosis than people who get the disease
through a mosquito bite, researchers have found that this is not the case.
Reuters Health Information 2002
medscape.com/viewarticle/436175?srcmp=id-060702
-- TUBERCULOSIS --
WHO WARNS EUROPE OF TB THREAT
The World Health Organization on Thursday reiterated its warning that urgent
efforts are needed to curb the spread of tuberculosis in Europe, particularly in
central and eastern countries.
Reuters Health Information 2002
medscape.com/viewarticle/436173?srcmp=id-060702
-- WEST NILE ENCEPHALITIS --
WEST NILE VIRUS TESTING BEGINS IN WESTERN CANADA
British Columbia health officials said on Wednesday they have begun testing for
West Nile virus, but added they do not think the disease has spread to Canada's
westernmost province.
Reuters Health Information 2002
medscape.com/viewarticle/436172?srcmp=id-060702
-- HIV/AIDS --
HIV INFECTION INCREASES THROMBOEMBOLISM RISK IN PATIENTS YOUNGER THAN 50
HIV-infected individuals younger than age 50 are at increased risk of venous
thromboembolism (VTE), investigators in New York report.
Reuters Health Information 2002
medscape.com/viewarticle/436102?srcmp=id-060702
RESISTANT HIV-1 PERSISTS AFTER TREATMENT INTERRUPTION AND RESUMPTION
Small populations of resistant HIV-1 persist, despite the return of a wild-type
genotype after interruption and resumption of antiretroviral treatment, and
influence response to treatment, according to a report in the May 15th issue of
The Journal of Infectious Diseases.
Reuters Health Information 2002
medscape.com/viewarticle/436100?srcmp=id-060702
COST-EFFECTIVENESS OF HAART CONFIRMED BY STUDY
The use of highly active antiretroviral therapy (HAART) is associated with a
lower rate of hospital admissions and a higher rate of outpatient visits among
HIV-infected patients.
Reuters Health Information 2002
medscape.com/viewarticle/435964?srcmp=id-060702
GENE SILENCING BY RNA INTERFERENCE SUPPRESSES HIV INFECTION IN HOST CELLS
Post-transcriptional gene silencing, a natural defense strategy used by
eukaryotes to ward off transposons and transgenes, may be harnessed one day to
combat HIV infection.
Reuters Health Information 2002
medscape.com/viewarticle/435932?srcmp=id-060702
ANTIRETROVIRAL THERAPY MAY PROTECT AGAINST COGNITIVE IMPAIRMENT IN HIV PATIENTS
In symptomatic HIV-positive patients, antiretroviral therapy may offset risk
factors associated with cognitive impairment, researchers report.
Reuters Health Information 2002
medscape.com/viewarticle/435926?srcmp=id-060702
FAT REDISTRIBUTION NOT COMMON IN HIV-INFECTED CHILDREN RECEIVING HAART
Lipodystrophy does not appear to be treatment-limiting for most HIV-infected
children receiving HAART, according to researchers at Baylor College of Medicine
in Houston.
Reuters Health Information 2002
medscape.com/viewarticle/436193?srcmp=id-060702
-- HIV/AIDS - GLOBAL/POLITICAL --
BRAZIL LAUNCHES FIRST ANTI-AIDS CAMPAIGN FOR HOMOSEXUALS
Brazil launched its first anti-AIDS campaign aimed specifically at homosexuals
on Tuesday to fight a rising infection rate among young gay men.
Reuters Health Information 2002
medscape.com/viewarticle/436081?srcmp=id-060702
HAART RESPONSE SIMILAR IN HIV-INFECTED EUROPEAN AND AFRICAN PATIENTS
Patients infected with the subtypes of HIV-1 common in Africa respond initially
to HAART as well as patients infected with the subtype that predominates in the
West, according to a report in the May 24th issue of AIDS.
Reuters Health Information 2002
medscape.com/viewarticle/435945?srcmp=id-060702
SKEWED HIV RISK FOR YOUNG AFRICAN WOMEN ATTRIBUTED TO OLDER AGE OF SEX PARTNERS
In sub-Saharan Africa, HIV infection rates have risen more rapidly in young
women than in young men.
Reuters Health Information 2002
medscape.com/viewarticle/434497?srcmp=id-060702
-- OTHER ID NEWS --
SECOND VARICELLA INFECTION NOT AS RARE AS PREVIOUSLY THOUGHT IN US
The assumption that natural chickenpox infection subsequently confers lifelong
immunity may not hold true in more cases than has been generally realized, based
on findings from a population-based study.
Reuters Health Information 2002
medscape.com/viewarticle/436087?srcmp=id-060702
RECEPTOR-BASED ANTIDOTE SHOWS PROMISE AGAINST DIPHTHERIA
A protein that binds to diphtheria toxin may make a safe and effective antidote
to the disease, according to researchers at the Texas Southwestern Medical
Center in Dallas.
Reuters Health Information 2002
medscape.com/viewarticle/436090?srcmp=id-060702
INFLAMMATORY PROCESS MAY INITIATE ATHEROSCLEROSIS IN HEALTHY MEN
In healthy men with low risk profiles, atherosclerotic development may be
precipitated by inflammation, according to a report in the May issue of the
Journal of Clinical Epidemiology.
Reuters Health Information 2002
medscape.com/viewarticle/434492?srcmp=id-060702
HERPESVIRUS CYTOKINE SPURS INFLAMMATION IN KAPOSI'S SARCOMA
Human herpesvirus 8-derived viral interleukin 6 (vIL-6) may trigger responses by
Kaposi's sarcoma (KS) cells that can result in increased tissue damage,
according to German researchers.
Reuters Health Information 2002
medscape.com/viewarticle/435980?srcmp=id-060702
COMPREHENSIVE, PRINTABLE DRUG INFORMATION
Medscape DrugInfo provides clinical information on drug
indications, adverse effects, interactions, and other
cautionary guidance, as well as handouts for your patients.
Click DrugInfo from the top of any page, or search by drug
name:
medscape.com/druginfo
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at the top of your home page. Or browse by specialty:
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_____________________________ USER SUPPORT ____________________________
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"
